Researcher:
Demir, Tuana

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Undergraduate Student

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Tuana

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Demir

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Demir, Tuana

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20181

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    Impact of the ST101 clone on fatality among patients with colistin-resistant Klebsiella pneumoniae infection
    (Oxford University Press (OUP), 2018) Menekse, Şirin; Karahan, Salih Nafiz; Azap, Oztem Kurt; Timurkaynak, Funda; Yavuz, Serap Şimşek; Basaran, Seniha; Yörük, Fugen; Azap, Alpay; Koculu, Safiye; Benzonana, Nur; N/A; N/A; N/A; N/A; N/A; N/A; Department of Industrial Engineering; N/A; N/A; N/A; Can, Füsun; İspir, Pelin; Ataç, Nazlı; Albayrak, Özgür; Demir, Tuana; Karaaslan, Doruk Can; Gönen, Mehmet; Lack, Nathan Alan; Ergönül, Önder; Kapmaz, Mahir; Faculty Member; Master Student; Researcher; Researcher; Undergraduate Student; Undergraduate Student; Faculty Member; Faculty Member; Faculty Member; Doctor; Department of Industrial Engineering; Koç Üniversitesi İş Bankası Enfeksiyon Hastalıkları Uygulama ve Araştırma Merkezi (EHAM) / Koç University İşbank Center for Infectious Diseases (KU-IS CID); School of Medicine; Graduate School of Health Sciences; N/A; N/A; School of Medicine; School of Medicine; College of Engineering; School of Medicine; School of Medicine; N/A; Koç University Hospital; 103165; N/A; N/A; N/A; N/A; N/A; 237468; 120842; 110398; N/A
    Objectives: We describe the molecular characteristics of colistin resistance and its impact on patient mortality. Methods: A prospective cohort study was performed in seven different Turkish hospitals. The genotype of each isolate was determined by MLST and repetitive extragenic palindromic PCR (rep-PCR). Alterations in mgrB were detected by sequencing. Upregulation of pmrCAB, phoQ and pmrK was quantified by RT-PCR. mcr-1 and the genes encoding OXA-48, NDM-1 and KPC were amplified by PCR. Results: A total of 115 patients diagnosed with colistin-resistant K. pneumoniae (ColR-Kp) infection were included. Patients were predominantly males (55%) with a median age of 63 (IQR 46-74) and the 30 day mortality rate was 61%. ST101 was the most common ST and accounted for 68 (59%) of the ColR-Kp. The 30 day mortality rate in patients with these isolates was 72%. In ST101, 94% (64/68) of the isolates had an altered mgrB gene, whereas the alteration occurred in 40% (19/47) of non-ST101 isolates. The OXA-48 and NDM-1 carbapenemases were found in 93 (81%) and 22 (19%) of the total 115 isolates, respectively. In multivariate analysis for the prediction of 30 day mortality, ST101 (OR 3.4, CI 1.46-8.15, P = 0.005) and ICU stay (OR 7.4, CI 2.23-29.61, P = 0.002) were found to be significantly associated covariates. Conclusions: Besides ICU stay, ST101 was found to be a significant independent predictor of patient mortality among those infected with ColR-Kp. A significant association was detected between ST101 and OXA-48. ST101 may become a global threat in the dissemination of colistin resistance and the increased morbidity and mortality of K. pneumoniae infection.